Can a Tooth That Needs a Root Canal Heal on Its Own?

When a tooth is causing significant pain or has been diagnosed with a deep infection, a root canal is usually the recommended treatment. But patients sometimes wonder whether there is any chance the tooth could recover on its own, especially if the pain comes and goes or seems to be getting slightly better. Here is an honest answer to that question.

What is happening inside a tooth that needs a root canal?

A root canal becomes necessary when the pulp inside the tooth, the soft tissue containing nerves and blood vessels, becomes either irreversibly inflamed or infected. There are two distinct stages worth understanding.

Reversible pulpitis is an earlier-stage inflammation where the pulp is irritated but still viable. At this stage, if the source of irritation, typically a cavity, is removed and the tooth is restored, the pulp can recover. This is not the stage that requires a root canal.

Irreversible pulpitis is when the inflammation has progressed to the point that the pulp cannot recover. The tissue is dying or already necrotic. At this stage, the infection or inflammatory response will continue to progress regardless of what the patient does. This is the stage that requires a root canal.

Can a tooth with irreversible pulpitis heal on its own?

No. Once the pulp has reached irreversible pulpitis or necrosis, it cannot regenerate or heal. The pain may temporarily subside, sometimes significantly, but this is not healing. It is often because the nerve tissue inside the tooth has died, which eliminates the pain signal while the infection continues to progress silently. The bacteria can spread through the root canals and out through the tip of the root into the surrounding bone, forming an abscess.

What happens if a root canal is postponed?

• The infection spreads into the surrounding bone, which can be difficult to treat and may threaten the viability of the tooth entirely

• An abscess may form, causing swelling, significant pain, and in some cases spreading to surrounding tissues

• The tooth may ultimately need to be extracted rather than saved

If you have a tooth that has been recommended for a root canal, prompt treatment gives the best chance of saving the tooth and preventing the infection from spreading. We can evaluate the tooth, explain what we are seeing, and help coordinate care with an endodontist if a root canal is indicated.